August 24, 2014

Using Cognitive Therapy With Medications Could Help Some Depression Patients

by Chuck Bednar

redOrbit Staff & Wire Reports - Your Universe Online

The chances that a person suffering from severe, nonchronic depression will make a full recovery increases by up to 30 percent if the individual is treated using a combination of cognitive therapy and antidepressant medication, a team of experts led by Vanderbilt University professor Steven Hollon claim in a new study.

Hollon and his colleagues conducted a randomized clinical trial involving 452 adult outpatients dealing with chronic or recurrent major depressive disorder (MDD). The patients were treated at university medical centers in Philadelphia, Chicago and Nashville, and either received antidepressants alone or in combination with cognitive therapy.

Those treatments lasted for up to 42 months until the patient had recovered. For the purposes of the study, the researchers declared that a patient was in remission if they experienced four consecutive weeks of minimal symptoms, and that they had recovered if they lasted another 26 consecutive weeks without suffering a relapse.

The results of the study, which were published online in the journal JAMA Psychiatry, found that combined treatment involving both cognitive therapy and antidepressant improved recovery rates when compared to drugs alone (72.6 percent vs. 62.5 percent).

However, the main effects of treatment on recovery were impacted by the severity and the chronic nature of the condition, the researchers explained. The advantage for combined treatment was limited to the 146 patients suffering from severe, nonchronic depression (81.3 percent vs. 51.7 percent). Recovery rates were also found to be similar in the two groups for patients suffering from less severe MDD or chronic MDD, they added.

“Our results indicate that combining cognitive therapy with antidepressant medicine can make a much bigger difference than we had thought to about one-third of patients suffering from major depressive disorder,” Hollon explained. “On the other hand, it does not appear to provide any additional benefit for the other two-thirds.”

“Now, we have to reconsider our general rule of thumb that combining the two treatments keeps the benefits of both,” the lead investigator and Vanderbilt psychology professor added in a statement Wednesday. “This provided us with enough data so that we could drill down and see how the combined treatment was working for patients with different types and severity of depression: chronic, recurrent, severe and moderate.”

According to Hollon, the results could have a significant impact on the way that MDD is treated – especially in the UK, which he said is a decade ahead of the US in terms of treatment for the condition. The use of combined cognitive therapy and antidepressive medicine is already standard for severe cases in the UK, and health officials there are training therapists in cognitive therapy and other empirically-supported forms of psychotherapy.

Other scientists involved in the study included Robert DeRubeis and Jay Amsterdam from the University of Pennsylvania; Jan Fawcett from the University of New Mexico; Richard Shelton from the University of Alabama-Birmingham; John Zajecka and Paula Young from Rush University; and Robert Gallop from West Chester University. The research was funded in part by grants from the National Institute of Mental Health.